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Viral eradication reduces both liver stiffness and steatosis in patients with chronic hepatitis C virus infection who received direct‐acting anti‐viral therapy
Author(s) -
Tada T.,
Kumada T.,
Toyoda H.,
Sone Y.,
Takeshima K.,
Ogawa S.,
Goto T.,
Wakahata A.,
Nakashima M.,
Nakamuta M.,
Tanaka J.
Publication year - 2018
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.14554
Subject(s) - medicine , steatosis , viral load , virology , virus , viral hepatitis , hepatitis c virus , viral disease , immunology , gastroenterology
Summary Background Whether direct‐acting anti‐viral therapy can reduce liver fibrosis and steatosis in patients with chronic hepatitis C virus ( HCV ) infection is unclear. Aims To evaluate changes in liver stiffness and steatosis in patients with HCV who received direct‐acting anti‐viral therapy and achieved sustained virological response ( SVR ). Methods A total of 198 patients infected with HCV genotype 1 or 2 who achieved SVR after direct‐acting anti‐viral therapy were analysed. Liver stiffness as evaluated by magnetic resonance elastography, steatosis as evaluated by magnetic resonance imaging‐determined proton density fat fraction ( PDFF ), insulin resistance, and laboratory data were assessed before treatment (baseline) and at 24 weeks after the end of treatment ( SVR 24). Results Alanine aminotransferase and homeostatic model assessment‐insulin resistance levels decreased significantly from baseline to SVR 24. Conversely, platelet count, which is inversely associated with liver fibrosis, increased significantly from baseline to SVR 24. In patients with high triglyceride levels (≥150 mg/dL), triglyceride levels significantly decreased from baseline to SVR 24 ( P = 0.004). The median (interquartile range) liver stiffness values at baseline and SVR 24 were 3.10 (2.70‐4.18) kP a and 2.80 (2.40‐3.77) kP a respectively ( P < 0.001). The PDFF values at baseline and SVR 24 were 2.4 (1.7‐3.4)% and 1.9 (1.3‐2.8)% respectively ( P < 0.001). In addition, 68% (19/28) of patients with fatty liver at baseline ( PDFF ≥5.2%; n = 28) no longer had fatty liver ( PDFF <5.2%) at SVR 24. Conclusion Viral eradication reduces both liver stiffness and steatosis in patients with chronic HCV who received direct‐acting anti‐viral therapy ( UMIN 000017020).